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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11363
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have been taking Tri-Sprintec for 14 months. I am starting

Customer Question

I have been taking Tri-Sprintec for 14 months. I am starting to get concerned by a few things. Recently in the last 3 weeks and more frequently the last three days, I have been experiencing vision problems. I have not been able to focus while wearing contact lenses. My vision is blurred particularly during daylight hours. I feel like I cannot see well 30 feet in front of me. I recently went to the eye doctor in September, so my prescription in contacts in up to date. I know that vision changes and trouble with contact lenses is a listed side effect of this medication. I have also been having moderate headaches in the back of my head. I called my doctor's office and the nurse told me: The doctor suggests you get a CT scan because this should not happen after a year of taking it. You need to make sure nothing else is wrong. procedures are not cheap and I really don't have money to spare. I'm so confused and don't know if I should stop taking Tri-Sprintec today. Also, I am a 25 year old female and my skin is begining to change and become dehydrated-- but I am experiencing moderate skin acne on my cheeks and chin during Week 3 of Active pills. Have these things happened to anyone else? I have been thinking about visiting my eye doctor tomorrow just to have them check. I have read that high estrogen can change the cornea shape, and I am concerned. I don't understand why my doctor will not have me in for a visit. I am not dizzy or why would he want me to visit the hospital?

Submitted: 4 years ago.
Category: Eye
Expert:  Dr. Rick replied 4 years ago.
Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

the most worrisome ocular side effect of this medication is the formation of a retinal thrombosis (blood clot). The symptoms you have reported are NOT suggestive of this type of problem.

Dr. Rick :

The other ocular side effect is a problem with contact lens wear. While the mechanism of this side effect -- which is the one you seem to be suffering from -- is not understood very well, after almost 20 years of clinical practice I believe that it is due to changes in the tear film and anterior surface of the eye.

Dr. Rick :

I have had excellent results with treating patients like yourself the same way I would treat patients who have a combination of dry eyes, allergies and blepharitis.

Dr. Rick :

Here is a handout on these conditions. While you may not have these exact clinical problems I discuss below, I want you to pay attention to the lid scrubs, natural tears and dry eye therapy.

Dr. Rick :

Here is the information:

Dr. Rick :

It sounds like you are suffering from an anterior segment/tear film issue. Many times, for all sorts of reasons, the anterior surface of the eye starts to have difficulties. What can cause this? Well, there are a number of conditions but the most common are dry eyes, allergies and blepharitis....many times all three conditions act together to make you miserable. In order to solve your problem you need to address all of these issues at the same time.

When it comes to allergies it is almost impossible to pin down the offending agent(s) and, therefore, treatment needs to focus on controlling the symptoms. Dry eyes are very common and can be improved by a stepwise series of therapies. First, the use of natural tears 4-6+ times/day to augment your natural tear production, if this doesn’t work then you can try temporary punctal occlusion of the lower puncta, then, if needed, temporary occlusion of all 4 puncta then, if indicated, surgical ( non-reversible) closure of the puncta. The openings to your tear drainage system are called puncta and you have one opening on each lid, near your nose.

Blepharitis is a condition where glands in the eyelids are not functioning normally. They become plugged and instead of putting out their normal clear, oily secretions, they put out thick, toothpaste like gunk. You may not be able to see this “gunk” yourself, unless it is really bad, but it shows up clearly on slit lamp examination.

The best treatment for this condition daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on your eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.

Baby shampoo lid scrubs will also help to wash away allergens and stimulate tear production, thereby addressing all three of your issues. Remember, this is not an instant fix. While you are waiting for the lid scrubs to have affect you can use over the counter allergy pills such as Travist, dimetapp or Zyrtec.

Should your symptoms get worse, your vision become significantly affected or things just not get better in 3 weeks or so you should have a complete eye examination by your local ophthalmologist to look for other, less common, causes of your symptoms.

Dr. Rick :

Give this a try. I think you will find that you can wear your contact lenses longer after a few weeks of the above therapy.

Dr. Rick :

Does this answer your question to your satisfaction?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.

Thanks in advance,

Dr. Rick

Dr. Rick :

I see that you are offline. I'll switch over to the Q&A system. This system works a lot like 'text messaging' but an email is sent to each of us anytime something is posted to this thread. We can continue to work on your question there..... :)